Provider Demographics
NPI:1922081371
Name:LANCASTER GENERAL MEDICAL GROUP
Entity Type:Organization
Organization Name:LANCASTER GENERAL MEDICAL GROUP
Other - Org Name:PENN MEDICINE LGHP FAMILY MEDICINE MANHEIM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT FINANCIAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-544-5010
Mailing Address - Street 1:700 LANCASTER RD
Mailing Address - Street 2:
Mailing Address - City:MANHEIM
Mailing Address - State:PA
Mailing Address - Zip Code:17545-2314
Mailing Address - Country:US
Mailing Address - Phone:717-665-2496
Mailing Address - Fax:717-665-6345
Practice Address - Street 1:700 LANCASTER RD
Practice Address - Street 2:
Practice Address - City:MANHEIM
Practice Address - State:PA
Practice Address - Zip Code:17545-2314
Practice Address - Country:US
Practice Address - Phone:717-665-2496
Practice Address - Fax:717-665-6345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-21
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA03128600OtherCAPITAL BLUE CROSS
PA1007327490073Medicaid
PA5897045OtherAETNA NON-HMO
PA85048OtherAETNA CAP OFFICE#
PA1518492OtherGATEWAY HEALTH PLAN
PA725913OtherHIGHMARK BLUE SHIELD
PA558423OtherAETNA HMO
PACD8099OtherRAILROAD MEDICARE
PAS1QHOtherGEISINGER HEALTH PLAN
PAS1QHOtherGEISINGER HEALTH PLAN